奥沙利铂为主联合化疗治疗预后不良的晚期非小细胞肺癌临床研究

Oxaliplatin-based regimen in advanced non-small cell lung cancer with poor prognosis

41例经病理或细胞学确诊的晚期非小细胞肺癌,接受奥沙利铂(L-OHP)为主的联合化疗.L-OHP分别联合吉西他滨(GEM)、去甲长春碱(NVB)、紫杉醇各15、21、5例.三组均予L-OHP 100～130 mg/m2,静脉滴入,d1;GEM组予GEM 1 000～1 250 mg/m2,静脉滴入,d1,d8;NVB组予NVB 25 mg/m2,静脉滴入,d1,d8;紫杉醇组予紫杉醇150～175 mg/m2,静脉滴入,d1.21 d为1个周期,每例患者至少治疗2个周期.共132个周期,平均3.2个周期.结果显示,总有效率14.6%(6/41),肿瘤控制率31.7%(13/41). 1年生存率26.8%(11/41),中位生存期7.2个月.主要的血液学不良反应为血小板减少,但Ⅲ～Ⅳ度减少仅占17.1%(7/41); 4例(9.8%)患者发生Ⅲ～Ⅳ度白细胞减少;5例(12.2%)患者输注了红细胞.非血液学不良反应大部分局限于Ⅰ～Ⅱ度,10例(24.4%)患者出现Ⅰ～Ⅱ度神经毒性,均可逆.初步研究结果提示,L-OHP为主的联合化疗方案治疗预后不良的晚期NSCLC有一定疗效;但其疗效能否与顺铂相比,仍有待临床的进一步研究.其不良反应较轻,耐受性较好.

The aim of this study was to evaluate the efficacy and toxicity of the oxaliplatine-based regimen in cases of advanced non-small cell lung cancer (NSCLC) with poor prognosis. A total of 41 patients (31 men, 10 women) with advanced NSCLC received oxaliplatine-based regimen. All patients were accessable for activity and toxicity. Six patients (14.6%) achieved partial response; seven (17.1%) had minor response. The median overall survival was 7.2 months. One-year survival rate was 26.8% (11/41). Four patients (9.8%) had Grade 3-4 neuropenia; six patients (14.6%) had Grade 3 anemia; seven patients (17.1%) had thrombocytopenia. Ten patients (24.4%) had Grade 1-2 neurotoxicity. In conclusion the oxaliplatine-based regimen has some activity in patients with advanced NSCLC and it is well tolerated.